Overturning No-Fault Denials: Your Guide to Winning Your Claim

Disclaimer: This article provides general information only and should not be taken as legal advice. Please consult with a qualified attorney for guidance specific to your situation.

Car accidents happen daily on New York and Long Island roads. While no-fault insurance should protect drivers and passengers, many people discover their claims denied – often wrongfully. Knowinghttps://www.adr.org/about-us how to challenge these denials can mean the difference between getting the benefits you deserve or drowning in medical bills.

Table of Contents

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• No-Fault Insurance in New York: What You Need to Know
• Why Insurance Companies Say “No”
• What New York Law Says About Your Rights
• Fighting Back: The Appeals Process
  • Making Your Appeal Strong
• Arbitration: A Faster Path to Resolution
• When to Call a Lawyer
• Picking the Right Legal Partner
• Take Action Now

No-Fault Insurance in New York: What You Need to Know

New York created its no-fault insurance system to help accident victims get quick payment for medical costs and lost wages, regardless of who caused the crash. The system requires insurers to cover up to $50,000 in necessary medical expenses, lost wages, and related costs. But insurance companies often put profits first, leading them to deny valid claims and leave accident victims struggling.

Why Insurance Companies Say “No”

Insurance companies deny claims for many reasons. Some denials are valid, but others deserve a fight. Here are the most common reasons they’ll give:

Medical necessity tops the list – insurers frequently claim your treatment wasn’t needed for accident-related injuries. Other typical denials involve:

• Missing the 30-day window to report the accident
• Missing or inadequate medical records
• Questioning if your injuries actually came from the accident
• Forms filled out incorrectly
• Breaking policy rules

What New York Law Says About Your Rights

The law requires insurance companies to play fair. They must:

• Look into claims thoroughly and quickly
• Tell you clearly why they denied your claim
• Handle claims promptly
• Look at all your evidence fairly

Insurance companies breaking these rules may face penalties beyond just paying your claim.

Fighting Back: The Appeals Process

Time matters when you’re denied. Here’s what you need to know about deadlines:

1. You usually have 30 days to appeal after getting denied
2. The insurance company must respond within 30 days
3. If they still say no, you can go to arbitration or court

Making Your Appeal Strong

Pack your appeal with proof:

• All your medical records
• Your doctors’ treatment plans
• Expert opinions backing up your care
• Accident reports
• Clear timeline of everything that happened
• Witness statements when helpful

Arbitration: A Faster Path to Resolution

Many people choose arbitration over court to resolve no-fault disputes. The American Arbitration Association handles these cases, making final decisions that both sides must accept. Cases with solid proof tend to win more often.

When to Call a Lawyer

While you might handle simple appeals yourself, get professional help when:

• Your medical bills are piling up
• You keep getting denied
• The insurance company acts unfairly
• Your medical situation is complicated
• Important deadlines loom

Picking the Right Legal Partner

Taking on insurance companies demands skill and grit. The Law Office of Jason Tenenbaum, P.C. consistently wins these battles for clients. We know New York insurance law inside and out, and we’ve spent years fighting – and winning – no-fault cases.

Our team recognizes the pressure you’re under when claims get denied. We fight hard to protect your rights and get you paid. Whether through talks, arbitration, or court, having us in your corner boosts your odds of success.

Take Action Now

Don’t let a denial letter be the final word. Read it carefully, collect your paperwork, and think about getting legal help. The Law Office of Jason Tenenbaum, P.C. offers case evaluations to review your situation and lay out your options. Remember – acting quickly gives you the best shot at overturning that denial and getting paid.

Note: Every case differs, so talk with a qualified attorney about your specific situation to get proper legal advice.